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目的了解再生障碍性贫血(AA)的发生与化学毒物接触的相关性。方法采用回顾性病例对照研究方法,选取2004年6月1日—2014年6月30日在金华市人民医院血液科再生障碍性贫血住院患者52例为病例组,选取与病例组同年龄、同性别和同期住院的非再生障碍性贫血患者204例为对照组,开展问卷调查,并对接触化学毒物与再生障碍性贫血发病的相关性作多因素Logistic回归分析。结果病例组和对照组均衡性较好(P>0.05)。两组化学毒物接触比例比较,差异有统计学意义(P<0.01),其中病例组有化学毒物接触史者为29.27%高于对照组的4.06%。两组在煤或石油、工业胶水、油漆、染发剂及工业染料5项间的接触率比较,差异均有统计学意义(P<0.05)。多因素分析显示煤或石油(OR=12.182,95%CI:1.099~134.977)、工业胶水(OR=16.367,95%CI:1.573~170.292)及染发剂(OR=3.496,95%CI:1.271~9.614)是导致再生障碍性贫血的危险因素。结论再生障碍性贫血发病可能与化学毒物接触相关,应加强对经常接触化学毒物人群的再生障碍性贫血防治知识宣传。
Objective To understand the relationship between the occurrence of aplastic anemia (AA) and exposure to chemical poisons. Methods A retrospective case-control study was conducted. Totally 52 hospitalized patients with hematologic aplastic anemia in Jinhua People’s Hospital from June 1, 2004 to June 30, 2014 were enrolled in this study. The patients with same age, 204 patients with non-aplastic anemia who were sex and the same period of hospitalization were selected as the control group and conducted a questionnaire survey. Logistic regression analysis was used to evaluate the correlation between exposure to chemical poisons and the incidence of aplastic anemia. Results The case group and the control group were well balanced (P> 0.05). There were significant differences between the two groups in the exposure rate of chemical poisons (P <0.01). The history of exposure to chemical poisons was 29.27% in case group and 4.06% in control group. There was significant difference in contact rate between the two groups in 5 items of coal, petroleum, industrial glue, paint, hair dye and industrial dye (P <0.05). Multivariate analysis showed that coal or oil (OR = 12.182, 95% CI: 1.099-134.977), industrial glue (OR = 16.367, 95% CI: 1.573-170.292) and hair dye (OR = 3.496, 95% CI: 9.614) is a risk factor for aplastic anemia. Conclusion The incidence of aplastic anemia may be related to the exposure of chemical poisons. Knowledge of prevention and control of aplastic anemia should be strengthened.